Objective：To assess the efficacy of total intravenous anesthesia （TIVA） with propofol and remifentanil in cervical vertebra surgery. Methods： One hundred patients receiving elective cervical vertebra surgery were randomly allocated to the following 4 groups：group DR, desflurane 1-2 MAC and remifentanil 0. 15-0.40 μg ·kg^-1 · min^-1 ; group DF,desflurane 1-2 MAC and repetitive boluses of fentanyl 0.05 mg; group PR,propofol 50-100μg · kg^-1 · min^-1 and remifentanil 0.15-0. 40 μg · kg^-1· min^-1 ;and group PF,propofol 50-100μg · kg^-1 · min^-1 and repetitive boluses of fentanyl 0.05 mg. During the anesthesia,the adverse cardiovascular response, the use of vascular active drug, time of extubation and time of directive movement resuming were recorded. The mental state and degree of pain were assessed by a blinded observer using simplified State-Trait-Anxiety Inventory （STAI） and Visual Analogue Scale （VAS） 90 min and 24 h after anesthesia. Moreover, the incidence of nausea and vomiting was also recorded. Results： The adverse hemodynamic response,time of extubation and directive movement resuming in group DR and PR were earlier than those in group DF and PF （P〈 0.05）. The STAI scores of TIVA were significantly lower than those of group DR and DF（P〈0.05） 90 min after anesthesia,but the difference disappeard after 24 h. The incidence Of nausea and vomiting in group DR and DF were significantly higher than those in other groups（P〈 0.05） 90 min and 24 h after anesthesia. There was no difference in VAS scores among all groups. Conelusion： The application of TIVA with propofol and remifentanil in cervical vertebra surgery has stable hemodynamics, quicker and complete awakening, good mental state,and reduced incidence of nausea and vomiting. It is worth recommending in clinical practice